Essence of Anesthesia Practice

Pulmonary Atresia

Risk PA/IVS occurs in 3% of all CHD and has a prevalence of 0.07:1000 live births. PA/VSD occurs in 3.4% of all CHD. 20% of all cases of TOF are physiologically similar to PA/VSD due to extreme pulm artery stenosis.…

Protein C Deficiency

Risk Congenital deficiency. Homozygote is estimated at 1:500,000-750,000 live births. Occurs when gene coding for protein C on both chromosomes #2 is affected. Heterozygote ∼0.2–0.4% of healthy population; 2–5% in pts with DVT. Acquired deficiency also seen. Perioperative Risks Pts…

Preterm Infant

Risk Births at less than 37 post conceptual wk (PCW) rose sharply from 1990 to 2006 in USA due to the increase in assisted reproductive technology and multiple gestation. It has been slowly declining in the ensuing years. In 2013,…

Pregnancy-Induced Hypertension

Risk Although the true incidence of PIH remains unknown, it is believed to complicate about 6–10% of pregnancies, contributing to one of the major causes of maternal, fetal, and neonatal mortality and morbidity. Perioperative Risks Short-term maternal risks: CNS dysfunction,…

Pregnancy, Maternal Physiology

Risk Estimated 6.4 million pregnancies in USA, resulting in 4.1 million live births per year. Pregnancy rate is 102 pregnancies per 1000 women between the ages of 15–44 y. Perioperative Risks Maternal mortality rate is 28 deaths per 100,000 live…

Pregnancy, Intra-Abdominal

Risk Incidence in USA: 11:100,000 live births and 9:1000 ectopic pregnancies. Higher incidence in African Americans, Asians, and immigrant populations from third-world countries. Risk factors include PID, tubal damage, intrauterine contraceptive devices, assisted reproductive techniques, previous ectopic, and previous pelvic…

Pregnancy, Ectopic

Risk Implantation of a fertilized oocyte outside the uterine cavity. 1.3–2.4% of all pregnancies, but rate is increasing due to risk factors and better diagnostic methods. Risk factors: High-tubal surgery, prior ectopic pregnancy, use of an IUD, interutero exposure to…

Preeclampsia

Risk 2–8% of all pregnancies Nulliparous, or multiparous with previous preeclampsia/eclampsia Hx, advanced maternal age Increased with Hx of obesity, chronic htn, diabetes, renal disease, SLE, thrombophilia Perioperative Risks Increased risk of fetoplacental or maternal deterioration necessitating (often operative) delivery.…

Prader-Willi Syndrome

Risk Prevalence: 1:25,000 Incidence: 1:10,000-15,000 Racial prevalence: None Gender predominance: Similar frequency in both sexes and all races Most common syndromic form of obesity, affects 350,000–400,000 individuals worldwide Annual death rate is 3% versus 1% in the general population, primarily…

Posttransplant Lymphoproliferative Disorder

Risk Cumulative incidence over 5 y: 1–2% in liver, 1–3% in kidneys, 2–6% in heart, 2–9% in lung, and 11–33% in intestinal or multiorgan transplants Major risk factors: EBV positive serology in the recipient (multisystem PTLD) EBV negative recipient and…